General Medical issues thread

[JohnM]

Many go for one distance and one close. Not for me tho. I went for two medium - distance lenses and happy to wear simple glasses for close reading. I can just use x2 magnifiers if needed but have gradhated glasses for reading and computer screen. Technology changed in the two years between getting second eye done and that lens is better than the first.

Works well for me but YMMV.

Fantastic thing when you get cataracts done is the brilliant colours you have been missing over the years. Whites are actually white not cream!

The ophthalmologist indicated that I could find that pharmac_ specs would work for reading, but I will see my optician about six weeks after the second eye is done and work it from there.

 

[TheRealTMA]

The ophthalmologist indicated that I could find that pharmac_ specs would work for reading, but I will see my optician about six weeks after the second eye is done and work it from there.

Yes agree. The optician will give you better calibration but it’s good to know that if you leave your real glasses behind, a cheap pharmac_ magnifiers will tide you over.

 

[RooFlyer]

I opted to prioritise long distance vision and equal eyes for good binocular vision as I do a lot of driving in the country and in rough situations. With my natural sight tending to one short/one long, the asymmetry was bugging me.

I've had contacts in both eyes for many years, with one short, one long and the brain resolves it fine. I wear glasses for reading and computers; the lens for the 'short corrected' eye has plain glass.

I had one eye's cataract done (set at long vision) after a gradual deterioration following retinal detachment surgery (this was expected); I asked why not both (like others have) and ophthalmologist explained that he didn't want to do the other eye until necessary. Drew me a curve of operation benefit (improvement over current vision) Vs operation risk and said I'm not nearly at the benefit/risk position yet.

So at the moment I just wear the one contact lens (short vision).

When that eye gets done, I'll get it set for short vision, to match what contacts have long done. Reason for me is, like now, that I can look at phone and food labels etc without getting the glasses out/on. I'll still have glasses for computer work and reading and they are optimised for the distance to my screens.

 

[zig]

I went with multifocal lenses and haven’t needed glasses for 5 years. After a lifetime of glasses or contact lenses it was life changing.
I do get halos around lights at night, so night driving can be a bit challenging, but I don’t drive much at night.

 

[prozac]

MRsProzac went to ENT today. After much prodding, pushing, twisting he determined she did not have BVVP, but cervical damage and or carotid artery narrowing. Pulled a bunch of detritus out of her ears (not wax, dead skin and stuff.. she's a swimmer). Said to me, "Have a look at this" through the microscope thingy. Referred for ultrasound carotids and cervical x-ray. Now I am whispering at her "Can you hear me now" She says yes.

 

[MARTINE]

I went with multifocal lenses and haven’t needed glasses for 5 years. After a lifetime of glasses or contact lenses it was life changing.
I do get halos around lights at night, so night driving can be a bit challenging, but I don’t drive much at night.

I am sure you have done so but get your pressures checked for glaucoma (which can present with halos at night).

 

[zig]

I am sure you have done so but get your pressures checked for glaucoma (which can present with halos at night).

Thanks, I get the pressures checked every 12 months. I was advised at the time of having the cataracts done that it was a known side effect of the multifocal lenses. I decided I could live with it.

 

[Quickstatus]

though a bit hard to work out as he had stents inserted for glaucoma as well.

Medicare rules are that the highest paid item number is paid at 100%, the second 50%, subsequent 25%

 

[Pushka]

Medicare rules are that the highest paid item number is 100%, the second 50%, the third 25% and subsequent 10%

So if the stents had been inserted on a different day to the cataracts then potentially all would have been covered unless the surgeon charged over that gap?

 

[Quickstatus]

So if the stents had been inserted on a different day

the 100%-50%-25% rules covers all the services at the one sitting
If separate days then first day item number = 100% medicare rebate, second day item number = 100% medicare rebate
As you can imagine its actually more complicated than that, sometimes a second item number is not claimable because it is deemed to be part of the first.

Nothing to do with gaps.

 

[andye]

MRsProzac went to ENT today. After much prodding, pushing, twisting he determined she did not have BVVP, but cervical damage and or carotid artery narrowing. Pulled a bunch of cough out of her ears (not wax, dead skin and stuff.. she's a swimmer). Said to me, "Have a look at this" through the microscope thingy. Referred for ultrasound carotids and cervical x-ray. Now I am whispering at her "Can you hear me now" She says yes.

Always difficult to make clinical judgements (or criticise colleagues) without full history and examination but carotid narrowing doesn't cause vertigo.
Very occasionally (i might see one patient every 2 years), significant vertebral artery (the blood vessels going up the back of the neck rather than the front) narrowing can do so if neck movements cause a kink.

 

[love_the_life]

So if the stents had been inserted on a different day to the cataracts then potentially all would have been covered unless the surgeon charged over that gap?

I think not - the doctor's fees were well over the schedule fee. Common in Canberra.

 

[JohnK]

Wife not well again. Feels like another UTI

- pain in the side
- urge to pee often and pee very warm with some pain urinating
- fever (quite bad a few hours ago, 2 nurofen did not help much followed by 2 panadol and now much better)
- chills
- nausea

The last UTI lasted 4-5 weeks with 4-5 different antibiotics. Haven't had chance to do UKB Ultrasound, we did check urine but doctor hasn't contacted the results. Either hospital again tonight if not better or medical centre tomorrow.

I think we're now at the stage where we have to start antibiotic as soon as wife gets symptoms. The past couple of hours have been torture watching wife suffer. Need to discuss with GP but he's been off sick the past 2-3 weeks and not sure when he'll be back. The medical centre doctors do not really cut it for long term care.

 

[drron]

Always difficult to make clinical judgements (or criticise colleagues) without full history and examination but carotid narrowing doesn't cause vertigo.
Very occasionally (i might see one patient every 2 years), significant vertebral artery (the blood vessels going up the back of the neck rather than the front) narrowing can do so if neck movements cause a kink.

Occasionally not. I had my first episode of psoriasis after a fall with an ankle injury and subsequent cellulitis. Reading a Dermatology journal an article suggested that up to 5% of psoriasis began after injury or infection. When I saw a dermatologist I mentioned that. Rubbish he said. Where did you find such garbage. I don’t think he was impressed when I said a Dermatology journal.
But in general you are correct.

 

[Quickstatus]

I think we're now at the stage where we have to start antibiotic as soon as wife gets symptoms

@JohnK you need to do more than just antibiotic. You NEED to get the ultrasound done + the usual blood tests and urine samples to try to find the bacteria. From there maybe even a CT.

From the symptoms you describe, the HOSPITAL is the best place. Dont muck around with half treatments and half diagnosis. Getting better after an antibiotic does not mean the problem has been cured.

 

[JohnK]

@JohnK you need to do more than just antibiotic. You NEED to get the ultrasound done + the usual blood tests and urine samples to try to find the bacteria. From there maybe even a CT.

From the symptoms you describe, the HOSPITAL is the best place. Dont muck around with half treatments and half diagnosis. Getting better after an antibiotic does not mean the problem has been cured.

Back in hospital at 4:00am. See how long they keep her this time. As mentioned previously the bacteria is e.coli and is resistant to penicillin, cephalexin and triprim but also resistant to ampicillin and gentamicin.

I left at 6:30am and they had given wife something for nausea and 1 endone which she managed to keep down and made her very groggy so she was getting some sleep.

The junior doctor was consulting with senior doctor and with me and wanted to give wife Augmentin via drip and see how wife responds. They've done bloods and urine. They were thinking of CT and I had to make mention, no contrast as that gave wife severe panic attack.

Wife hasn't eaten since lunch yesterday. We'll go see her tonight but this is now becoming an issue with recurring infections.

 

[Sprucegoose]

I think not - the doctor's fees were well over the schedule fee. Common in Canberra.

There is a special tax on everything in Canberra being more expensive and not necessarily as good!

 

[Quickstatus]

Canberra

I have a friend in Canberra who says when he gets sick he goes to the Hume Highway.

 

[Quickstatus]

doctor

Well done for taking your wife to hospital. They got to get to the bottom of it.and you are correct - recurring infections mean something is not right.

 

[JohnK]

Well done for taking your wife to hospital. They got to get to the bottom of it.and you are correct - recurring infections mean something is not right.

I'm not a doctor but I'm now thinking Lupus as a possibility. Wife has had pain and swelling in feet which is not exactly consistent with the rheumatoid arthritis diagnosis so possibly both autoimmune diseases.

And it's always the right flank which is the flank damaged with the hysterectomy and damage to the ureter when daughter was born. This is not negativity but wife has not been the same since.